How does it work?

Telehomecare brings health care services right to your home with easy-to-use equipment. You will learn more about your condition and take charge of your health - knowing that a Telehomecare Nurse is there to support you and help you get the care that you need.

You will learn how to manage your daily health (including diet, medication management and exercise) and become more aware of the signs and symptoms.

From your home, you will work one-on-one with a nurse to set your own health goals. Through regularly scheduled coaching sessions, learn skills to make positive lifestyle changes.

Remote monitoring equipment is easy to use and allows the Telehomecare Nurse to continually monitor your vitals for early intervention. Each day, you will use the equipment to check your vital signs, like your blood pressure, weight, heart rate and oxygen levels.

This program is time-limited. It is a way for your health care provider to help you stay healthy and at home.

Who can participate?

Telehomecare is appropriate for patients who:

are living with Chronic Obstructive Pulmonary Disease (COPD) or Heart Failure (HF)

are over 18 years of age

have had frequent emergency room visits or hospital admissions in the last year related to their condition

are capable of learning and understanding instructions; or have a care provider to assist; and

live in a residential setting with an active landline

The program is currently available in limited areas in Ontario. Speak to your health care provider for more details.

Who will be caring for me?

A Telehomecare Nurse, trained in chronic diseases, becomes part of your overall care team. The Nurse will help you set goals, and will provide health coaching to empower you to take care of your own health.

Your Telehomecare Nurse will also partner with your health care provider and other members of your care team, keeping them regularly informed and working with them to care for you. You will continue to have appointments with your health care provider as required.

What is Health Coaching?

Health coaching will help to guide you to take control of your own health. It involves goal setting, problem solving and finding ways to help you make healthy changes. Health coaching will help you build the skills to review your own situation, make decisions and plan for healthy living.

What is Self-Management?

Self-management focuses on a collaborative partnership between you and your Telehomecare Nurse. At the centre of this partnership are your priorities, challenges and the skills you need to help you to live well and have healthy behaviours. Your nurse will give you resources that match your own attitudes, beliefs, culture and preferences so you can take control of your health.

Once enroled in the program, what do I have to do?

Your Telehomecare Nurse will support you to:

set healthy living goals

complete tasks using the Telehomecare equipment (for example, use a blood pressure cuff to take your blood pressure)

submit daily readings, and

engage in short education sessions using the telephone

How long is the Program?

This program is time-limited and on average lasts six months. It is a way for your primary care provider to help you stay healthy and at home. Based on your progress, and through consultation with your primary care provider, your nurse will determine how long you should be involved in the Telehomecare Program.

What happens when I finish the Program?

At the end of the Program, you will have learned skills that you can use over the longer term and you will have been introduced to local health and community services to support you. A discharge summary is provided to your primary care provider who will continue to support your care plan.

How do I get the equipment and is it hard to use?

A member of the Telehomecare team will deliver the equipment to your home, install it and show you how to use it. The Telehomecare equipment is easy to use, and is loaned to you. No computer or Internet service is required. The program uses your phone line for a brief period each day at the time of your convenience.

What if my condition gets worse?

You and your Telehomecare Nurse are partners in managing your health. If there are any concerns with your daily submissions, your Telehomecare Nurse will call you to talk about your condition. Your Telehomecare Nurse and your health care provider will also connect regularly to talk about your progress.

Do I have to pay for this service?

No. This program is paid for by the Government of Ontario and Canada Health Infoway.

Will my privacy be protected?

The Personal Health Information Protection Act, Ontario 2004 (PHIPA) is a provincial law that sets out the rules for health care providers to collect, use and share your personal health information. It also gives you the right to ask to see and ask for changes to your personal health information if the information is inaccurate or incomplete.

Only your health care provider, your Telehomecare Nurse and other members of the primary care team caring for you will see your personal health information. OTN staff may need limited access to your personal health information when they provide technical help to your primary care provider. Only staff members who need access to the system to do their jobs will have access to your personal health information. For more information, visit the Privacy section.

What is a Best Practice Organization?

Best Practice Spotlight Organizations (BPSO®) are health-care and academic organizations which partner with the Registered Nurses’ Association of Ontario (RNAO) to facilitate the formal implementation and evaluation of clinical best practices. OTN was awarded the designation of BPSO® Candidate on behalf of the Telehomecare Expansion Program.

This means that your Telehomecare Nurses combine their clinical expertise, and your values and preferences with best research evidence to support you in the management of your health and to focus on quality of life.